Inguinal hernia is the most common type of hernia, mainly seen in men. Its location is in the area between the torso and the thigh and it may be right, left or bilateral. An inguinal hernia occurs when an intra-abdominal organ (most commonly fat and the small intestine) protrudes through a weak point of the lower abdominal wall. This projection can cause discomfort and pain, especially when the person is coughing or bending, or when he/she lifts a heavy object.
In several cases, especially in the early stage of the disease, the hernia has no specific symptoms. However, the abnormal bulb in the groin (in either side of the pubic bone) can be felt during palpation. Sometimes, there is a sense of “itching” or “burning” and, as the disease progresses, a persistent pain is felt in the area.
In early stages, the content of the hernia returns easily back to the abdominal cavity (reducible hernia). Progressively though, the organ inside the hernia sac may be blocked (in-reducible hernia) and if the blood supply is harvested, a serious complication will emerge, called strangulation. This complication puts in risk the viability of the organ within the hernia (more often the small intestine), and can lead to bowel necrosis, if not urgently treated.
The symptoms of a strangulated hernia are:
- Acute pain in the groin
- Erythema of the groin
- No passage of bowel gas and
And in more advanced stage:
- Diffuse abdominal pain
It should be noted that a hernia with few or even absent symptoms is equally dangerous to a hernia with more severe symptoms.Furthermore, a small-sized hernia is more likely to get strangulated than a larger one. In order to avoid any complications caused by this “benign” disease, every type of hernia should be repaired surgically, immediately after diagnosis.
The revolution in the surgical treatment of inguinal hernias is the minimally invasive (laparoscopic) approach with placement of a mesh
The main advantages of this method are the absence of large incisions, the absence of postoperative pain and the immediate return of the patient to his/her daily activities. The extraperitoneal endoscopic technique (TEP – Totally Extraperitoneal Repair), is considered as the optimal approach for definitive hernia repair. TEP is one of the safest techniques, since the procedure is performed outside the abdominal cavity, within the layers of the abdominal wall. Therefore, the operation restores the original anatomy by putting the mesh and strengthening the abdominal wall on its base. By using this method, the recurrence rate in inguinal hernia repair is below 0.5%.